Thyroid No Surgery: Beware of Physicians Ordering Unnecessary Thyroid Ultrasounds and Biopsies.
- Thyroid ultrasound is not a screening test. It is a test that is used when there are indications.
- Family history of thyroid cancer, goiter or Hashimoto’s thyroiditis.
- Hypothyroidism without a abnormal neck exam is not an indication.
- Finding a nodule on ultrasound is not an indication for a biopsy.
- There are criteria for which nodule is at risk for thyroid cancer.
- Very Low Risk nodules do not need a biopsy. Spongiform nodules and pure cysts.
- Hypoechoic nodules with no other features are not suspicious also does not need a biopsy.
- Taller than wide is mildly suspicious and if > than 2.5 cm need a biopsy.
- Lobulated or irregular margins or extra -thyroidal extension are moderately suspicious and need a biopsy if > 1.5 cm.
- High risk include marked hypoechoic nodules, taller than wide nodules, and nodules with aggressive margins and some types of calcifications are highly suspicious and need a biopsy if 1.0 cm.
- Before you have a thyroid ultrasound be sure it is indicated by your history and family history.
- Thyroid nodules are very common so if you have an indication to have an ultrasound make sure you have a nodule that is not low risk. If you have some risk make sure the size of the nodule matches the risk.
- Once you have the ultrasound or biopsy when it was not indicated you are on a slippery slope leading to unnecessary surgery.
- If you have any doubt about the need for ultrasound or biopsy get an outside opinion first.
- Contact me at 310-393-8860 or firstname.lastname@example.org.